Provider Demographics
NPI:1841182284
Name:GUIDING STAR PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:GUIDING STAR PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TESKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-284-6369
Mailing Address - Street 1:3390 ANNAPOLIS LN N STE C
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-5379
Mailing Address - Country:US
Mailing Address - Phone:763-284-6369
Mailing Address - Fax:
Practice Address - Street 1:3390 ANNAPOLIS LN N STE C
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5379
Practice Address - Country:US
Practice Address - Phone:763-284-6369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty